Predictors of functional recovery in patients admitted to geriatric postacute rehabilitation.

Details

Serval ID
serval:BIB_E0B43EEA5463
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predictors of functional recovery in patients admitted to geriatric postacute rehabilitation.
Journal
Archives of Physical Medicine and Rehabilitation
Author(s)
Seematter-Bagnoud L., Lécureux E., Rochat S., Monod S., Lenoble-Hoskovec C., Büla C.J.
ISSN
1532-821X (Electronic)
ISSN-L
0003-9993
Publication state
Published
Issued date
2013
Volume
94
Number
12
Pages
2373-2380
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVE: To examine characteristics associated with functional recovery in older patients undergoing postacute rehabilitation.
DESIGN: Observational study.
SETTING: Postacute rehabilitation facility.
PARTICIPANTS: Patients (N=2754) aged ≥65 years admitted over a 4-year period.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURE: Functional status was assessed at admission and again at discharge. Functional recovery was defined as achieving at least 30% improvement on the Barthel Index score from admission compared with the maximum possible room for improvement.
RESULTS: Patients who achieved functional recovery (70.3%) were younger and were more likely to be women, live alone, and be without any formal home care before admission, and they had fewer chronic diseases (all P<.01). They also had better cognitive status and a higher Barthel Index score both at admission (mean ± SD, 63.3±18.0 vs 59.6±24.7) and at discharge (mean ± SD, 86.8±10.4 vs 62.2±22.9) (all P<.001). In multivariate analysis, patients <75 years of age (adjusted odds ratio [OR]=1.51; 95% confidence interval [CI], 1.16-1.98; P=.003), women (adjusted OR=1.24; 95% CI, 1.01-1.52; P=.045), patients living alone (adjusted OR=1.61; 95% CI, 1.31-1.98; P<.001), and patients without in-home help prior to admission (adjusted OR=1.39; 95% CI, 1.15-1.69; P=.001) remained at increased odds of functional recovery. In addition, compared with those with moderate-to-severe cognitive impairment (Mini-Mental State Examination score <18), patients with mild-to-moderate impairment (Mini-Mental State Examination score 19-23) and those cognitively intact also had increased odds of functional recovery (adjusted OR=1.56; 95% CI, 1.13-2.15; P=.007; adjusted OR=2.21; 95% CI, 1.67-2.93; P<.001, respectively).
CONCLUSIONS: Apart from sociodemographic characteristics, cognition is the strongest factor that identifies older patients more likely to improve during postacute rehabilitation. Further study needs to determine how to best adapt rehabilitation processes to better meet the specific needs of this population and optimize their outcome.
Pubmed
Web of science
Create date
12/01/2014 16:48
Last modification date
20/08/2019 16:04
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